目的 分析评价骨水泥柄双极人工股骨头置换治疗高龄股骨转子间骨折的临床疗效.方法 2009年2月~2012年7月收治42例股骨转子间骨折患者,男15例,女27例,平均83(76~92)岁;骨折按AO系统分型:A12型9例,A21型13例,A22型14例,A23型6例.入院到手术时间平均为6(4~9)d,8例使用施乐辉加长柄,34例使用标准骨水泥柄.术后1 w内、1个月、6个月、1年拍随访X片,并进行髋关节Harris评分.结果 平均随访时间20.6(7~42)个月,平均手术时间75(50~110)min,平均出血量360(200~1200)ml.术后平均下床时间5(3~10)d.术后6个月Harris评分优10例,良20例,中7例,差2例,总优良率76.9%.1例患者手术后1个月发现钢丝断裂,行钢丝取出后恢复良好.结论 骨水泥型人工股骨头置换治疗高龄转子间骨折,术后恢复快,减少了卧床时间,降低了并发症,提高了患者生活质量.%Objective To analyze the clinical effects of cemented stem bipolar artificial thigh bone replacement on senile patients with intertrochanteric fracture. Methods From February 2009 to July 2012, there were 42 patients with intertrochanteric fracture,including 15 male cases and 27 female ones with an average age of 83(76-92 years old). According to the classification of AO grouping system,there were 9 cases belonged to type A12,13 ones to type A21,14 ones to type A22,and 6 ones to type A23. The average time between admission and operation was 6 d(4-9 d). Eight cases used the Smith & Nephew long handle and 34 cases used the standard bone cement handle. Respectively 1 w,l month,6 months,and 1 year after the operation,X-ray films were taken,and Harris scoring of the hip joint was made. Results The average time of follow-up was 20. 6 months(7 to 42 months) ;the average operative time was 75 minutes(50410 minutes) ;the average blood loss was 360 ml(2004200 ml) ;the average time of getting out of bed after the operation was 5 d(340 d). Six months after the operation ,the Harris scores in 10 cases were excellent,in 20 ones were good,in 7 ones were fair,and 2 ones were poor. The total excellence and good rate was 76. 9%. Wire fracture occurred in one case 1 month after the operation. The recovery was good after the removal of the wire . Conclusion The treatment of senile patients with intertrochanteric fracture by cemented stem bipolar artificial thigh bone replacement can achieve a quick postoperative recovery , less lying time in bed, and lower rate of complications. Patients'quality of life can be improved.
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